Department of Epidemiology, Unit Health Technology Assessment, University Medical Center Groningen, The University of Groningen, Groningen, The Netherlands.
Value Health. 2013 Jun;16(4):490-7. doi: 10.1016/j.jval.2012.12.007. Epub 2013 Feb 20.
Productivity losses usually have a considerable impact on cost-effectiveness estimates while their estimated values are often relatively uncertain. Therefore, parameters related to these indirect costs play a role in setting priorities for future research from a societal perspective. Until now, however, value of information analyses have usually applied a health care perspective for economic evaluations. Hence, the effect of productivity losses has rarely been investigated in such analyses. The aim of the current study therefore was to investigate the effects of including or excluding productivity costs in value of information analyses.
Expected value of information analysis (EVPI) was performed in cost-effectiveness evaluation of prevention from both societal and health care perspectives, to give us the opportunity to compare different perspectives. Priorities for future research were determined by partial EVPI. The program to prevent major depression in patients with subthreshold depression was opportunistic screening followed by minimal contact psychotherapy.
The EVPI indicated that regardless of perspective, further research is potentially worthwhile. Partial EVPI results underlined the importance of productivity losses when a societal perspective was considered. Furthermore, priority setting for future research differed according to perspective.
The results illustrated that advise for future research will differ for a health care versus a societal perspective and hence the value of information analysis should be adjusted to the perspective that is relevant for the decision makers involved. The outcomes underlined the need for carefully choosing the suitable perspective for the decision problem at hand.
生产力损失通常对成本效益估计有重大影响，而这些估计值往往相对不确定。因此，从社会角度来看，这些间接成本相关参数在为未来研究确定优先次序方面发挥作用。然而，到目前为止，信息价值分析通常在经济评估中采用医疗保健视角。因此，在这些分析中，生产力损失的影响很少被调查。本研究的目的是调查在信息价值分析中包含或排除生产力成本的效果。
在从社会和医疗保健角度对预防成本效益进行评估时，进行了预期信息价值分析（EVPI），使我们有机会比较不同的视角。通过部分 EVPI 确定未来研究的优先次序。预防阈下抑郁患者发生重度抑郁的计划是机会性筛查，随后是最低限度的接触心理治疗。
EVPI 表明，无论从哪个角度来看，进一步的研究都是有价值的。当考虑社会角度时，部分 EVPI 结果强调了生产力损失的重要性。此外，根据视角的不同，未来研究的优先次序也有所不同。
结果表明，对于医疗保健与社会角度，建议未来的研究会有所不同，因此信息价值分析应根据相关决策者的视角进行调整。结果强调了为手头的决策问题选择合适视角的必要性。
